Many people are influenced by the wrong publicity of pornography, although the time is not short, but think that their time is not long enough; many others say that sex can not control ejaculation, is what we usually say “fast shooter” – premature ejaculation. What exactly is premature ejaculation? How to determine and treat it? In fact, on the one hand, this is the misunderstanding of no correct sexual knowledge, pornography is cut, no one can reach that long, and not the longer the better, can effectively control ejaculation, to achieve pleasure: according to foreign surveys found that most normal people’s ejaculation latency (from insertion to ejaculation) is 5-10 minutes, the best sex time is 7 minutes; on the other hand, women’s pleasure is slower, more focused on the emotional basis, foreplay and ejaculation. more focused on the emotional basis, foreplay and subsequent caresses, and the true duration of sex does not need to be too long. There are various definitions of premature ejaculation, but the one that can be accepted by most experts is: ejaculation before or within 1 minute after penile penetration into the vagina, reduced ejaculatory control, and adverse psychological and emotional effects on both partners. Premature ejaculation is the most common male sexual dysfunction, with an incidence of about 30% in the population. Causes of premature ejaculation It is generally believed that primary premature ejaculation is caused by elevated central or peripheral nerve sensitivities. Some fraudulent hospitals therefore measure what nerve sensitivity is, but it is not very meaningful. Most tests for premature ejaculation are by assessment scales, and the available instruments are not particularly effective. Only if the cause of secondary premature ejaculation needs to be found, some tests are needed. The true cause of premature ejaculation remains a difficult mystery. There are some arguments that premature ejaculation is a problem on a purely psychological level, due to a pattern of fast-acting sexual behavior in men whose early sexual experiences (including masturbation) are often done under the tension of fear of being discovered. Some scholars have also found that patients with premature ejaculation are physiologically prone to arousal and overly sensitive reactions. Some scholars even believe that premature ejaculation represents an evolutionary behavioral pattern of the species: males who are able to ejaculate in a shorter period of time have a higher chance of fertilizing females and reproducing offspring. Treatment of premature ejaculation Treatment of premature ejaculation includes psychological and behavioral therapy, topical therapy, oral medication, and surgery. The goal of treatment is to improve the patient’s ability to control ejaculation by increasing the sensory domain values of the penis and adjusting behavioral reflexes. In the past, time was often used as an indicator, which was neither objective nor measurable in real time, affecting the patient’s perception of treatment and assessment of its effectiveness. Psychological and behavioral treatment of premature ejaculation needs to be performed by a professional psychologist, and the effectiveness is closely related to the experience of the physician. A common method is sexual concentration training. Behavioral therapy includes increasing the frequency of ejaculation, adopting a female on male sexual position, stop and start ejaculation, squeeze technique, and pelvic floor muscle contraction exercises. Specifically: when the male feels the ejaculation is about to pause, the woman immediately lift the body from the male, or even press the glans below for three to four seconds to reduce arousal, and then continue after a break of 15 to 30 seconds. Other methods include diversions and changes in body position can also be used. In addition, the improvement of the relationship between husband and wife or sexual partners, emotional rapport, open communication, mutual understanding of the sexually sensitive areas of both parties, as much as possible more sexual foreplay and post-sex care, can improve sexual satisfaction and naturally solve the tension and shock caused by premature ejaculation on the sexual life of both parties. The purpose of local penile treatment is to reduce the sensitivity of the penis head and penile skin and increase its sensory domain value. Such as the use of condoms, circumcision deng. Local treatment is commonly used 2% lidocaine gel, applied to the head of the penis 10 minutes before intercourse to reduce the sensation of the penis and prolong the latency time of ejaculation. It can be washed away during sexual intercourse or with a condom. The shortcomings of topical treatment for premature ejaculation are numbness of the penile head and decreased pleasure. There are medications available specifically for the treatment of premature ejaculation. The only 5-hydroxytryptamine reuptake inhibitor in the world that has an indication for premature ejaculation is dapoxetine (Bilirubicin), which has a fast onset of action and is taken 1-2 hours before each sexual intercourse; there are other drugs such as tricyclic antidepressants (chlorpromazine, etc.) and selective 5-hydroxytryptamine reuptake inhibitors (fluoxetine, sertraline and paroxetine, etc.) for premature ejaculation. These medications are slow to take effect and generally require two weeks of continuous medication before the ejaculation time is felt to be prolonged. Once the medication takes effect, it can also be taken as needed 3-4 hours before sexual intercourse. The adverse effects of these drugs are nausea, dizziness and erectile dysfunction. Surgical methods for premature ejaculation are less commonly used and the results are not yet definitive. The main principle is to selectively cut the sensory nerves in the head of the penis and reduce the sensitivity of the head. Before treatment, it needs to be completely ineffective after medication and behavioral treatment, and the ejaculation time can be prolonged after applying local anesthetics to the penis before going to a regular hospital for surgery. At present, most of the advertised hospitals are carried out by unregulated hospitals and doctors, with more complications and very harmful. In the treatment, the patient must unload his psychological baggage and discuss his hidden illness with the physician, who in turn must listen carefully to the patient and perform the necessary tests to understand the real cause of premature ejaculation, whether it is primary or secondary, whether it is a problem of his own factors or social and cultural background, etc. If the ejaculation is primary, medication should be applied to enhance ejaculatory control, supplemented by behavioral therapy to consolidate and maintain the ejaculatory control; if it is secondary, factors causing sexual tension should be excluded, and the patient should be relaxed and both partners should cooperate and understand each other to achieve harmonious interaction under the premise of correct sexual education and guidance; if this is still ineffective, the causative factors should be actively treated, supplemented by If this is still ineffective, we should actively treat the causative factors, supplemented by drugs and behavioral therapy to enhance ejaculation control, then premature ejaculation can be solved! In conclusion, the diagnosis and treatment of premature ejaculation is in continuous progress, and a new scientific understanding of premature ejaculation is needed, and the shift from “protracted war” to “control theory” is a deepening and sublimation of understanding. We must realize that effective “control” is the hard truth, abandoning the concept of “protracted war”, so that the spoilers or shadows of sexual life away from a pleasant sex life as soon as possible.